| Advanced Therapy Associates, Llc | |
|
9212 N Kelley Ave Ste 200 Oklahoma City OK 73131-2419 | |
| (405) 242-5070 | |
| (405) 242-5071 |
| Full Name | Advanced Therapy Associates, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 9212 N Kelley Ave Ste 200, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Elisabeth Pesce (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9046054986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Therapy Associates, Llc 9212 N Kelley Ave Suite 200 Oklahoma City OK 73131-2419 Ph: (405) 242-5070 | Advanced Therapy Associates, Llc 9212 N Kelley Ave Ste 200 Oklahoma City OK 73131-2419 Ph: (405) 242-5070 |
| NPI Number | 1558506857 |
|---|---|
| Provider Enumeration Date | 12/16/2008 |
| Last Update Date | 12/16/2022 |
| Certification Date | 12/16/2022 |
| Medicare PECOS PAC ID | 1951624576 |
|---|---|
| Medicare Enrollment ID | O20150106000900 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558506857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Sophie H L Lam Germany |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669709788 PECOS PAC ID: 4880737964 Enrollment ID: I20100211000655 |
| Provider Name | Christine Mcglashen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588727069 PECOS PAC ID: 0840513461 Enrollment ID: I20150106001026 |
| Provider Name | Joseph Cox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265762884 PECOS PAC ID: 7012087380 Enrollment ID: I20150331000990 |
| Provider Name | Audra Yadack |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851611602 PECOS PAC ID: 6800177999 Enrollment ID: I20170104000455 |
| Provider Name | Felicia Dawn Cummings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235255746 PECOS PAC ID: 9931566809 Enrollment ID: I20230607003925 |
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